Today Claire Bowes looks back at the so-called Sars epidemic of the early
2000s when a newly identified respiratory illness caused fear across the globe.
Between the end of 2002 and the summer of 2003, Severe Acute
Respiratory Syndrome killed more than 700 people and made thousands more ill.
Life had almost come to a standstill as travel restrictions were imposed to try
to contain the virus. But on June 5th the World Health Organisation had some
good news. "We think right now that the epidemic is behind us it's not in front
of us anymore. What comes next we're not sure. The
numbers are reassuring and we're glad to have them come down but if people were
to drop their guard now it would be very premature." At last it seemed that the
nightmare which had begun in Guangdong southern China in late 2002 might be
coming to an end. But Sars might never have reached the rest of the world had
it not been for a wedding invitation. In late February
having just treated patients with what was termed atypical pneumonia Dr Liu Jianlun
from Guangdong, checked into room 911 of the Metropole Hotel
in Hong Kong to attend a family wedding. It may have been just a single sneeze in
the lift that infected seven others who then took the virus to Canada, Singapore
and Vietnam. Hong Kong became the epicentere. My name's Tom Buckley I'm the
Chief of Service of the Intensive Care Unit of the Princess Margaret Hospital
in Hong Kong. And my concerns as the Director of the Intensive Care Unit
was that all these patients were coming into the Intensive Care Unit, nobody was
getting better and I remember after about five or six days worrying that we
were almost full, I only had one empty bed left. And I can remember lying
on the couch at home trying to sleep but couldn't sleep because I was wondering
what am I going to do? Where am I going to send the next patient after that?
And about five o'clock in the morning I got the call to say that there was another
patient who needed to come to ICU.
My name is William Ho. I was the
Chief Executive of the Hong Kong Hospital Authority. What we adopted was a method
of what we call cohorting - that is all patients with pneumonia will be kept
together and they will be separately treated. Even the medical staff divided
themselves into what they call the clean team and the dirty team who are the
clean team are those who haven't really touched any of the patients in that
ward and they will continue to look after patients in other wards and other
areas. Whereas the dirty team volunteer themselves to continue looking after the
patients in that ward and they will not touch other patients. So that's the best
that we could do at that time.
Many staff went and stayed in hotels, I slept on
my office floor when I did go home I would sleep on the couch in the living
room. I would go home late at night and I would leave first thing in the morning
before my children got out of bed or my wife got out of bed. At home a series
of guidelines were established for how to be at home if you had to go home. We
all started wearing masks at home which is really quite surreal, we had to
separate everything - toothpastes so because of the risk of contamination. The
guidelines started to come out about how to use the toilet. There are studies that
have been shown that if you don't put the toilet lid down that when you flush
the toilet the droplets from the toilet bowl will reach the ceiling.
Atypical pneumonia can be transmitted by respiratory droplets and by contact with
the patient secretions. To reduce the chances of infection wash your hands
frequently with liquid soap and dry them with a disposable towel. Wash your hands
before touching your eyes, nose or mouth. Avoid shaking hands. Wash your hands
after touching public...
Initially the public were relatively uninformed about what
was actually happening. As the government became more responsive to the situation
they started to see flyers on the television about this form of atypical
pneumonia. It was interesting watching how the
percentage of people wearing masks gradually increased from zero,
up to about 50 to 60 percent over the course of about ten days. So the public
became very aware very quickly about what was going on and took measures into
their own hands. They didn't go to the racecourse, they
didn't eat out or go to restaurants as much, they didn't go shopping.
By the 22nd of March
with the virus at its height, the Chief Executive of the Hong Kong
Hospital Authority, William Ho,
addressed an international Sars
conference in Hong Kong.
And I was the one giving you the first lecture on that
day, nine o'clock in the morning and during lunch break I also went away to pay another
visit to the colleagues in the Prince of Wales Hospital and then I had to come
back for the latter part of conference the dinner etc. That was a Saturday. By
Sunday morning I already felt a bit dizzy and feverish became worse and I mean I
just wanted to exclude Sars so I went to one of our hospitals to have an x-ray taken.
When the x-ray came back it was conclusive.
It was the the typical x-ray of Sars.
So I knew immediately that I was a
Sars patient and my colleagues were really having grim faces. At that time,
even up to that moment, I couldn't imagine that I would have got Sars. So
that was a terrible shock to me. I couldn't think straight because your
life seems to be suddenly cut off.
It was headline news even the Chief
Executive of the Hospital Authority could get Sars. In early April the WHO
advised people not to travel to Hong Kong while those living there were
panicking.
Probably 80% of our friends left Hong Kong and people decided to
quarantine themselves and my wife and I decided on a contingency plan for our
family - that if it became more extensive in the community we would quarantine our
compound which has seven families. And if it became a problem within the compound
then my family would quarantine themselves in the house. I would go to
the supermarket put the food at the door and I would leave.
Meanwhile at the hospital
William Ho had been admitted to an isolation unit.
There was no set treatment for Sars but the doctors were
experimenting with steroids and antivirals.
So they decided since
I was reasonably young they could start with a real high dose. So I was put
on massive doses of these drugs trying to save my life. But of course all
the drugs would come with side effects. First of all my veins all got thrombosed
because of the irritation by the drug to my veins. So they were inflamed,
my arms were swollen and then after a while and they couldn't find suitable
veins. And I kept on asking what's happening outside? How's the
epidemic going? Whether the Prince of Wales outbreak had been under control
etc. So it's a lot of a psychological burden as well. I guess I'm not a typical
patient I couldn't rest my mind because it's also all my staff out there
fighting this disease. The virus was spreading inside my lung and the
epidemic was spreading in the hospital system so it was a double worry to me.
Dr Ho was fortunate, he made a complete recovery.
Those were really the darkest
days in Hong Kong although I was all the while in hospital I could you look at
what was there on TV. The airports and the streets were just eerily empty,
eerily empty and the economy suffered tremendously. But then
the whole society was united. The neighbours would take care of the kids
for healthcare workers who would dare not go home. And there was lots of
support for the ones fighting Sars. So that was a good demonstration of
solidarity that can be possible in our society. I hope that will linger.
William Ho and Tom Buckley spoke to the BBC World Service in 2004. That edition of
Witness History was produced and presented by Claire Bowes and if you'd
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